HISPC State Legal Working Group

Consent Subgroup

Meeting Archive

by Date in CCYYMMDD format

20070912

Agenda_20070912 (pdf)

Minutes_20070829 (pdf)

20070829

Agenda_20070829 (pdf)

Minutes_20070801 (pdf)

20070801

Agenda_20070801 (pdf)

Minutes_20070711 (pdf)

WorkPlan_20070801 (pdf)

Draft Ohio Model Permission Form_20070801.pdf

Committee Assignments_20070801 (pdf)

20070711

Agenda_20070711 (pdf)

Resources

Medicaid

HIPAA Consent form

The HIPAA Guide to Privacy Act

The Medicaid HIPAA general site

This site contains the Ohio release form and other links, including federal forms.

The Public Records and Confidentiality Booklet is located here

and is fairly complete. Caution, this site is updated as laws change in order to remain current.

To assist in navigating the ODJFS web pages, the site index is located

here.

This site reflects the complexity of our agency, simply by the number of links on the index.

Bureau of Workers' Compensation

BWC HIPAA fact sheets

BWC HIPAA forms

Current BWC medical release form

Ohio law relevant to the release of medical information to the Ohio Bureau of Workers' Compensation

and other parties in the Ohio workers' compensation system:

Ohio Revised Code 4123.651(B):

"The bureau of workers’ compensation shall prepare a form for the release of

medical information, records, and reports relative to the issues necessary for the administration of a claim

under this chapter. The claimant promptly shall provide a current signed release of the information, records,

and reports when requested by the employer. . . ."

Ohio Administrative Code 4123-6-20(D):

"In accepting a workers’ compensation case, a medical provider assumes

the obligation to provide to the bureau, claimant, employer, or their representatives, MCO, QHP, or

self-insuring employer, upon written request or facsimile thereof and within five business days, all medical,

psychological, or psychiatric documentation relating causally or historically to physical or mental injuries

relevant to the claim required by the bureau, MCO, QHP, or self-insuring employer, and necessary for the

claimant to obtain medical services, benefits or compensation."

The information below may or may not be relevant to the purposes of this group:

Ohio law relevant to the release of medical information held by the Ohio Bureau of Workers' Compensation and

its subcontracted Managed Care Organizations (MCOs) to other parties in the Ohio workers' compensation system:

Ohio Revised Code 4123.88

(A) . . . No person shall, without prior authority from the bureau, a member of the commission, the claimant,

or the employer, examine or directly or indirectly cause or employ another person to examine any claim file or

any other file pertaining thereto. No person shall forge an authorization for the purpose of examining or cause

another person to examine any such file. No district or staff hearing officer or

other employee of the bureau or commission, notwithstanding the provisions of section 4123.27 of the Revised

Code, shall divulge any information in respect of any claim or appeal which is or may be filed with a district

or staff hearing officer, the bureau, or commission to any person other than members of the commission or to

the superior of the employee except upon authorization of the administrator of workers' compensation or a

member of the commission or upon authorization of the claimant or employer.

(B) The records described or referred to in division (A) of this section are not public records as defined in

division (A)(1) of section 149.43 of the Revised Code. Any information directly or indirectly identifying the

address or telephone number of a claimant, regardless of whether the claimant's claim is active or closed, is

not a public record. No person shall solicit or obtain any such information from any such employee without

first having obtained an authorization therefore as provided in this section.

(C) Except as otherwise specified in division (D) of this section (an exception for access by journalists),

information kept by the commission or the bureau pursuant to this section is for the exclusive use and

information of the commission and the bureau in the discharge of their official duties, and shall not be open

to the public nor be used in any court in any action or proceeding pending therein, unless the commission or

the bureau is a party to the action or proceeding. The information, however, may be tabulated and published

by the commission or the bureau in statistical form for the use and information of other state agencies and

the public.

Ohio Administrative Code 4123-3-22(A):

Authorizations for representation shall be in writing and signed by the

authorizing party. When the authorization is on behalf of the employee, it shall be filed on an “Authorization

of Representation of Injured Worker” form. There shall be a separate authorization filed with the bureau for

each claim to which the authorization is to extend. The authorization card shall remain with the application

for benefits until a claim file is established, at which time the authorization shall be made a part of the

claim file. When the authorization is on behalf of the employer, a blanket authorization may be filed with the

claims section in Columbus and with the local district and/or branch office.

(D) The inspection of claim files shall be limited to:

(1) The parties and/or their duly authorized representatives . . . ;

(2) Any other person authorized, in writing, by either the employee or the employer; such authorization having

been executed within sixty days prior to its use;

(3) Members of the general assembly when in the course of their duties as such;

(4) The governor, a select committee of the general assembly, a standing committee of the general assembly, the

auditor of state, the attorney general, or the designee of any, in the pursuance of any duty imposed by

Chapters 4121. and 4123. of the Revised Code.

(5) Duly authorized employees of governmental agencies whose official duties require the information contained

in the claim files;

(6) Such other persons as are specifically authorized by a member of the commission or the administrator

pursuant to the provisions of section 4123.88 of the Revised Code.

(I) Representatives of the parties may have copies of any material in the claim file, provided that copying

costs are paid.

Links to injured worker and employer authorization forms:

https://www.ohiobwc.com/downloads/blankpdf/r-2.pdf

https://www.ohiobwc.com/downloads/blankpdf/AC-02.pdf

https://www.ohiobwc.com/downloads/blankpdf/AC-3.pdf

Mental Health

HIPAA Policy (pdf)

Substance Abuse

Sample Form (pdf)

Physicians

Sample from Hilliard Pediatrics (pdf)

Pre-HIPAA Consent Form (pdf)

HIV/AIDS

AIDS Fact Sheet (pdf)

Public Health

From ODH (pdf)

To ODH (pdf)

Below are the links for 42 CFR Part 2 related to consent forms and redisclosure of information.

http://a257.g.akamaitech.net/7/257/2422/13nov20061500/edocket.access.gpo.gov/cfr_2006/octqtr/42cfr2.31.htm

http://a257.g.akamaitech.net/7/257/2422/13nov20061500/edocket.access.gpo.gov/cfr_2006/octqtr/42cfr2.32.htm

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